One of the most valuable tips that I feel I can give to surgeons in training is to learn how to perform an ultrasound examination.

It is important that the surgeon himself perform the ultrasound examination, as an integral part of the patient's clinical examination. Many reasons for doing it:

• It is possible to view the living viscera, rather than simply consulting static photographs of them;

• The surgeon, unlike the radiologist, has visited the patient and can compare in real time what she/he observes by ultrasound scanning with what she/he observed during the clinical examination;

• The surgeon does not perform a generic ultrasound examination, but uses the ultrasound scanning to deepen the clinical diagnosis and look for signs in the patient that confirm or deny her/his diagnostic suspicions, according to what emerged during the clinical examination;

• Performing the ultrasound examination by moving the probe and interpreting the images that change on the screen in real time, develops an essential skill in the surgeon: that of recreating in his mind a three-dimensional image of the inside of his patient's body. This ability can be transferred to reading a CT scan, to the interpretation of radiological images and, ultimately, to the concept phase of a laparoscopic surgical operation.

In the "Surgical Education Resources" section, I have included my self-made intestinal ultrasound manual, with several images that I collected in twenty years of experience in ultrasound applied to surgery. The manual is freely downloadable.

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